10 Surprising Facts About CBD

by Sarah Ludwig Rausch Health Writer

With an increasing number of states legalizing cannabis, products made from cannabidiol (CBD) are becoming more and more mainstream. We wanted to get educated, so we asked two experts to discuss some lesser-known facts about CBD. Here’s what our experts David Kroll, Ph.D., professor of natural products pharmacology at the Colorado University Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora, CO, and Ryan Vandrey, Ph.D., a professor in the Behavioral Pharmacology Research Unit at Johns Hopkins University School of Medicine in Baltimore, told us.

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CBD From Hemp or Marijuana—There’s a Difference

The cannabis plant contains more than 500 chemicals. CBD is just one of them, along with the well-known tetrahydrocannabinol (THC), a chemical that causes intoxication. Hemp refers to cannabis plants that contain 0.3% or less THC, while marijuana is a cannabis plant with any amount over 0.3% THC, a quantity that can cause euphoria, or a “high.” As of 2018, it’s federally legal to grow hemp in the United States. CBD can be extracted from either hemp or marijuana, but if you’re looking for CBD with trace or no THC content, make sure it’s from hemp.

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CBD Probably Won’t Get You High

Up until as recently as 2020, Kroll says there was a high probability that a CBD product would have some residual THC, often enough to create a euphoric effect. It’s still possible, of course, but he says many companies have been better about making pure CBD products. Vandrey notes that it also depends on how much and in what formulation you take CBD. For example, if you take 10 times the normal dose of CBD product that has minimal concentrations of THC, you could get intoxicated. This is especially true if you smoke or vape it.

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CBD Extracted From Hemp Is Federally Legal…

…but CBD that’s extracted from marijuana or has more than 0.3% THC content is federally illegal. To complicate matters, state laws differ. Some states consider it illegal to possess CBD at all, while in Washington D.C. and 11 states, it’s legal to have CBD extracted from either hemp or marijuana. States also regulate CBD products differently, Kroll says. For instance, he says states like Virginia require CBD sold there to only come from authorized growing facilities. Not sure what the laws are where you live? Check with your state’s agricultural department or The National Cannabis Industry Association’s map.

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Using CBD Can Cause You to Fail a Drug Test

Even though CBD products made from hemp may only contain trace amounts of THC, Kroll says it’s still often enough to show up on a drug test because they are so sensitive. So even if you don’t feel impaired, you could fail a new-job drug test when you’re ingesting or inhaling CBD if it contains THC (it’s less likely with topical products), says Vandrey. A recent study in Vandrey’s lab showed that pure CBD won’t cause a positive drug test, but since consumer CBD products aren’t regulated for their composition, THC content could be higher than you realize, Kroll notes.

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You Can Use CBD in a Variety of Ways

CBD products have a range of formulations—oils, edibles, sprays, capsules, and tinctures that you ingest or put under your tongue; smoking or vaping; and creams, lotions, salves, gels, and oils that you rub into your skin. There are even CBD skin patches. Kroll cautions that although topicals don’t have as strong of an effects as when you ingest or inhale them, you should still check your product for THC—if there’s enough (and you use a whole lot of it), it can get into your bloodstream through your skin and make you feel high.

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There Are Different Qualities of CBD products

Because CBD is treated as a consumer product rather than a drug—similar to a dietary supplement—“the quality and composition can vary wildly,” Kroll says. Just as the amount of THC can vary, so can the amount of CBD in products, despite what the label says. “When we did an analysis of CBD oils purchased off the Internet, we found a greater-than-800-fold difference in the concentration of CBD in the liquid,” Vandrey explains. There is an FDA-approved CBD seizure medication (Epidiolex), but you can’t assume other CBD products will be equal or work the same, says Vandrey.

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There Are Also Different Forms

CBD products generally come in three forms: pure CBD, full-spectrum, and broad-spectrum. Pure CBD is 100% CBD, though even these can have a small amount of THC, Kroll says. Full-spectrum CBD contains extracts from all the chemicals in the cannabis plant, including THC. Broad-spectrum CBD is similar, but it doesn’t include all the chemicals and it doesn’t have any THC. “There is anecdotal evidence for what’s called ‘the entourage effect,’” says Kroll, a belief that taking the chemicals together increases their effectiveness, which is why some people choose full- or broad-spectrum CBD. Research hasn’t yet proven how well it works.

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CBD Is for Everything From Pain to Anxiety

Keep in mind that the FDA has not approved CBD for anything other than rare forms of seizure disorders. Still, believers use CBD most frequently for chronic pain and anxiety. “For anxiety, it appears that CBD works through a serotonin receptor called 5HT1A, similar to the prescription drug buspirone (Buspar),” Kroll says. For pain, he says CBD seems to work as an anti-inflammatory, as well as working directly on ion channels that transmit pain impulses. “It’s important to know that CBD does not act on the same receptors that THC does, which is why it’s non-intoxicating,” he explains.

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CBD Can Interact With Other Meds You’re Taking

Studies done with the FDA-approved Epidiolex show that it can cause drug interactions with other epilepsy drugs, as well as medications like certain ones used for anxiety, hypertension, and allergies. “We know from those clinical studies that CBD can inhibit some of our drug metabolizing enzymes for other drugs,” says Kroll. The problem is that we don’t yet know how the lower doses of CBD found in consumer products may affect other medications you’re taking, which is why both Kroll and Vandrey say it’s so important to talk to your pharmacist or doctor before you use CBD.

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The Dosage Matters

“What dose works for what condition? We don’t have that level of science yet for anxiety or pain,” Kroll says. And remember, when you hear CBD is helpful for multiple health conditions, “it’s not always going to be the same product or the same dose that would be helpful for all of those things,” Vandrey cautions. In other words, you can’t assume that what seems to be effective for seizures will be the same for pain or anxiety. Kroll says that as long as your pharmacist has given you the all-clear regarding drug interactions, it’s OK to experiment with CBD.

Sarah Ludwig Rausch
Meet Our Writer
Sarah Ludwig Rausch

Sarah Ludwig Rausch is a health writer and editor whose specialties include mental health, diseases, research, medications, and chronic conditions. She’s written for The Christian Science Monitor, American Cancer Society, Cleveland Clinic, PsychologyToday.com, MedShadow Foundation, the ACT Test, and more.